Integrating the Healthcare Enterprise International – IHE Eye Care Webinar Series July 2018 • Peter Scherer, Principal at PS IT International • IHE Eye Care Co-Chair Technical Committee • Abdiel Marin, CEO EyeMD EMR Healthcare Systems, Inc. • IHE Eye Care Planning Committee and Technical Committee Member
A short introduction to IHE • IHE is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. • In 1997, a consortium of radiologists and information technology experts formed IHE, or "Integrating the Healthcare Enterprise." • IHE created and operates a process through which interoperability of health care IT systems can be improved. The group gathers case requirements, identifies available standards, and develops technical guidelines that manufacturers can implement. • The core philosophy of IHE is to identify and evaluate existing standards and define commonly agreed rules how to use these standards to fulfill specific healthcare use cases (workflow requests) the so called ‘Integration Profiles’. • IHE is sponsored by the Healthcare Information and Management Systems Society (HIMSS) and the Radiological Society of North America (RSNA). 7/17/2018 2
The IHE Eye Care Domain • In 2005 the American Academy of Ophthalmology (AAO) recognized the benefits of IHE and became the sponsor of IHE Eye Care. This enables clinicians and vendors to adapt IHE specific to the needs of the eye care business. • The AAO recommends clinicians use eye care vendors that implement IHE Integration Profiles as this greatly reduces the efforts of system to system information exchange. • IHE Eye Care provides the venue for vendors to test their products. This is a multiple vendor event, where multiple companies work together to test against real-world scenarios encountered in an eye care clinic. This AAO sponsored event is called the IHE Eye Care Connectathon. • The AAO also holds an “interoperability showcase” in which vendors assemble to demonstrate the interoperability of their products to eye care healthcare professionals. 7/17/2018 3
Basics Today the IHE Eye Care Definitions are using mainly 4 well known Health Care IT standards: HL7 (Health Level 7) V2.x HL7 V2.x is used to communicate administrative and non-imaging data such as patient demographics, appointment schedules, and more DICOM (Digital Imaging and Communications in Medicine) V3 DICOM V3 is used to store and communicate imaging data for eye care devices such as a fundus camera, slit lamp, visual field, OCT and more HL7 V3 CDA HL7 V3 CDA is the base of many C-CDA document templates describing multiple aspects of a patient history, such as a patient’s eye care exam or a patient’s eye care summary. The documents are used to communicate health care information beyond the local health care network. Japan Ophthalmic Instruments Association (JOIA) XML file based specification enabling the exchange of refractive measurements from devices such as autorefractors, keratometers, lensometers, etc. 7/17/2018 4
Basics (continued) • IHE is a framework or architecture for achieving a useful clinical workflow involving all kind of IT systems used in the healthcare environment. • IHE EyeCare abstracts real world use cases to Integration Profiles . • Actors are used to abstract tasks that are involved in a use case. • Transactions are used to abstract the communication between the Actors to fullfill the workflow of the use case. There are Mandatory and Optional Transactions for each Actor. • This results in a matrix defining the functionlities and communication abilities between two or more vendor products that interact within eye care healthcare organizations providing a seemless workflow to the healthcare professional. 7/17/2018 5
IHE Eye Care definitions • IHE Eye Care defines these Integration Profiles: Unified Eye Care Workflow, Eye Care Charge Posting, Eye Care Evidence Document, Eye Care Displayable Report • IHE Eye Care defines these Actors: Acquisition Modality, Acquisition Modality Importer, Appointment Consumer, Appointment Scheduler, Charge Processor, Content Consumer, Content Creator, Department System Scheduler/Order Filler, Evidence Creator, Image Display, Image Manager/ Image Archive, Image Storage/Display, Patient Registration Consumer, Patient Registration Source, Performed Procedure Step Manager, Refractive Measurement Source, Refractive Measurement Consumer, Refractive Measurement Source Importer • IHE EyeCare defines these Transactions: Appointment Scheduling Management, Eye Care Charge Posted, Modality Images/Evidence Key Objects Stored, Modality Images/Evidence Stored, Modality Procedure Step Completed, Modality Procedure Step In Progress, Patient Demographics Update, Patient Registration, Procedure Scheduled, Query Images, Query Modality Worklist, Retrieve Images, Refractive Measurements with Valid Patient ID, Refractive Measurements without Patient ID 7/17/2018 6
Profiles & Technical Frameworks Unified Eye Care Workflow • Automated Workflow in your practice • Patient Safety in Mind - input patient information once • Products such as Practice Management Systems (PMS), Electronic Medical Record Systems (EMRs), Image Management (PACS), Image Display Workstation and eye care Imaging Devices • Expanded to include EMR to refractive device measurement integration – Japan Ophthalmic Instruments Association (JOIA) XML-based refractive measurements • Standards used – HL7 v2.5.1 messages, DICOM SOP Classes and JOIA XML streams • All other workflows Retired – Advanced Eye Care Workflow - Retired – Basic Eye Care Workflow - Retired – Core Eye Care Workflow - Retired Pick the workflow configuration that fits your practice 7/17/2018 7
Real World Model I EHR provides DICOM patient list to devices & uses Image Management System (PACS) to archive images and reports Practice Management System Image Display • Patient Demo & Appointments Based Upon HL7 v2.5.1 • Device Patient List Patient Demographics Advanced Post Charges (Worklist) and & Image Display (Optional) Images/Reports Appointments (DICOM) • Advanced Image Display (DICOM) Image Management System (PACS) Electronic Health Record 7/17/2018 8 Eye Care Device
Real World Model II EHR provides DICOM patient list to devices & stores/displays key DICOM images and reports (no PACS) Practice Management System • Patient Demo & Appointments Based Upon HL7 v2.5.1 Patient • Device Patient List Demographics Post Charges & Appointments (Worklist) and (Optional) Images/Reports (DICOM) • Storage & Display of Key Images on EHR Electronic Health Record • Devices and Users responsible for safekeeping of images 7/17/2018 9 Eye Care Device
Real World Model III EHR does NOT support DICOM features (HL7 only) & integrates with PACS that supports DICOM patient list to devices and archival of images/reports Practice Management System Image Display • Patient Demo & Appointments Based Upon HL7 v2.5.1 • EHR sends Patient and Patient Order info to PACS Advanced Post Charges Demographics Image Display (HL7) (Optional) & Appointments • Orders/Demographics PACS provides patient list to devices (DICOM MWL) Image Management System • PACS archives (PACS) Electronic Health Record images/reports (DICOM) • Advanced Image Display (DICOM) 7/17/2018 Eye Care Device 10
Profiles & Technical Frameworks Unified Eye Care – Pat Registration and Appointments Practice Management System ↓ Patient Registration Patient Registration [EYECARE-15] Charge Processor ↓ Merge Patient IDs Source [EYECARE-20] Appointment Scheduler ↓ Appointment Scheduling Mgt. Electronic Health Record System [EYECARE-16] Patient Registration Consumer Appointment DSS/ Consumer Order Filler → Eye Care Charge Posted [EYECARE-17] Merge Patient IDs and Eye Care Charge Posted is optional 7/17/2018 11
Profiles & Technical Frameworks Unified Eye Care – Real World Model I Patient Registration ↓ Patient Registration Source Appointment Scheduler [EYECARE-15] Patient Registration ↓ Appointment Scheduling Mgt. Consumer DSS/ Appointment [EYECARE-16] Order Filler Consumer Image Display Evidence Creator ↓ Query Images ↓ Modality Images [EYECARE-5] ↓ Retrieve Images /Evidence Stored [EYECARE-3] [EYECARE-2] Image Manager/ → Procedure Scheduled [EYECARE -21] Image Archive → Patient Demographics Update [EYECARE -19] ↑ Modality Images Acquisition Modality /Evidence Stored or ← Query Modality Worklist [EYECARE -1] [EYECARE-2] Acquisition Modality Importer 7/17/2018 12
Profiles & Technical Frameworks Unified Eye Care – Real World Model II Practice Management System Patient Registration ↓ Patient Registration Source Appointment Scheduler [EYECARE-15] Electronic Health Record System ↓ Appointment Scheduling Mgt. Patient Registration DSS/ [EYECARE-16] Consumer Order Filler Appointment Consumer Image Storage/ Display ↑ Modality Images /Evidence Key Objects Stored [EYECARE-18] Acquisition Modality or Acquisition Modality Importer ← Query Modality Worklist [EYECARE -1] 7/17/2018 13
Recommend
More recommend
